Mga Trabaho sa Carelon Global Solutions sa Pilipinas

This role involves managing a team of clinicians and medical coders to promote quality member outcomes and optimize benefits. · ...

Responsible for managing a team of clinicians and/or medical coders to promote quality member outcomes. · Ensures adherence to medical policy in providing high-quality service. · ...

· Responsible for working with business partners to identify and implement small to medium projects that support achievement of simple to complex unit or corporate goals. · ...

The Payroll Manager shall be responsible for ensuring that the payroll & time keeping functions are operating effectively. · Manage payroll function & department. · Coodinate with vendor on processing of payroll. · ...

The job requires serving in an interim basis as a nurse trainee in the USRN Clinical Academy while obtaining NCLEX certification and USRN license prior to being deployed to a USRN function. · A BA/BS degree · An active unrestricted PHRN license to practice as a health professiona ...

Clinical Trainer conducts training needs analysis and designs learning solutions facilitates knowledge transfer activities for new employees measures tracks and evaluates learner performance coordinates training delivery integrates changes to workflow participates in calibration ...

Responsible for analyzing designs developing implementing and evaluating training solutions for business performance gaps based on business needs. · Conducts training needs analysis designs develops implements and evaluates effectiveness of learning solutions; · Facilitates knowl ...

This is a Sr. Operations Manager position responsible for providing oversight of customer service staff. · ...

The Medical Coding Quality Analyst evaluates the quality of services and interactions provided by organizations within the enterprise. · Evaluates the quality and accuracy of transactions and/or communications with providers, groups, and/or policyholders. · ...

Responsible for providing marketing support for National Account, Large Group and Group Retiree Solutions client events. · Works directly with designated client contacts to determine meeting options... · B.A/BS degree required. · ...

Responsible for serving as the operations point of contact for Medical Management and /or Medical Coding day to day operations, including but not limited to, facilitating issue resolution, meeting goals and targets. · Acts as a liaison for both internal and external groups for pr ...

Responsible for evaluating the quality of services and interactions provided by organizations within the enterprise. · ...

Responsible for performing both real-time analysis and scheduling functions as determined by current business need. · ...

Responsible for analyzing designing developing implementing and evaluating training solutions for business performance gaps based on business needs. · Conducts training needs analysis designs develops implements and evaluates effectiveness of learning solutions; · Facilitates kno ...

The Clinical Validation Auditor is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs billed and reimbursed. · ...

This position involves responding to customer inquiries via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims. · Responds to customer questions via telephone and written correspondence regarding insurance benefits, provi ...

++Responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs billed and reimbursed. · Specializes in review of Diagnosis Related Group (DRG) paid claims. · ...

The Medical Coding Manager will manage a team of clinicians and/or medical coders responsible for promoting quality member outcomes. · ...

Clinical quality analyst responsible for auditing inpatient medical records to ensure clinical documentation supports conditions and DRGs billed and reimbursed. · ...

The Security Risk Analyst will conduct open-source research and datamining to identify emerging issues, · assist with the development of scheduled and ad-hoc intelligence reports, · and provide actionable insights for decision-making. · ...